Real-time video transmission of ultrasound images to an iPhone

Abstract

Background As point-of-care ultrasound spreads across the globe, there is an increased need for training and supervision of ultrasound studies. Real-time oversight is important, especially in critically ill patients, but often an expert ultrasound over-read is not available on location. Technological advances have improved data transmission so that images and videos can be sent great distances very rapidly. In this study, we examine the feasibility of real-time wireless transmission of ultrasound video to an iPhone. Methods An ultrasound machine was connected via a video converter to a laptop. iCam (SKJM, LLC) software was used to transmit the video across the Atlantic Ocean to an iPhone. Images typical for those performed in an emergency department were sent, in random order by a 'scanning physician.' An 'interpreting physician' overseas was asked to identify the anatomy, presence or absence of pathology, and comment on the quality, speed, and delay of transmission. Results Rapid image transmission was feasible and the 'interpreting physician' was always able to correctly identify the anatomy and orientation. The average delay was minimal (2.7 s), allowing for real-time feedback. The frame rate was markedly slower in the received images as compared to the transmitted images, and was faster when the iPhone was connected via WiFi (1.1 fps) versus a 3G connection (0.4 fps). Conclusion Transmission of real-time ultrasound video to a remote iPhone using inexpensive technology is feasible, with the preservation of image quality and minimal delay. Transmission speed was superior with a WiFi connection than with a 3G connection.

Cost-Effective Remote iPhone-Teathered Telementored Trauma Telesonography

“…Thus, although the POC provider was an experienced ultrasound user, he still required remote mentoring to obtain diagnostic images. In comparison with Liteplo et al, 4 we found the frame rate was near real time, allowing easy recognition of physiologic processes such as lung sliding. For documentation purposes, we captured the color Doppler signal from the visceral-parietal pleura to confirm lung sliding.…”

Telesonography in emergency medicine: A systematic review

“…Data security measures were reported in a minority of papers. Discussion was limited to a brief statement confirming the use of an encrypted communication channel and authentication systems [ 15 , 18 , 19 , 25 , 26 , 32 , 33 , 42 ]. Phantoms, healthy volunteers and patients with chronic illnesses were frequently used as ultrasound subjects and in many instances these subjects had either gross ultrasound findings or none at all.…”

“…Many articles reported substantial issues with both image quality and transmission failure when using very low bandwidth (0.13-200Kbps) [ 16 , 19 , 21 , 32 – 35 , 39 , 40 ]. It might therefore be suggested that to construct an effective telesonography system the absolute minimum bandwidth requirements are above 500 kbps for general use [ 15 ].…”

Pediatric emergency medicine point-of-care ultrasound: summary of the evidence

“…Investigation is needed into the potential use of communications technology to facilitate real-time tele-echocardiography/POCUS image transfer for consultation with pediatric intensivists or resuscitation experts in critical care or emergency scenarios [110, 150–152]. …”